De-epithelialized overlap flap to secure urethroplasty in second stage hypospadias repair: revisiting the Smith technique.

Background: The application of a second layer between the neourethra and skin was a major contribution, which has improved the outcome of hypospadias repair. Here, we report our experience of revisiting the original Smith technique using a de-epithelialized overlap flap to support the urethroplasty in staged hypospadias repair.

Methods: The study included primary cases of proximal hypospadias with significant chordee who underwent two-stage repair during the period 2016 through 2021.